 Genetics
 Susceptibility Factors
Legend:
Disease process
Complications
Diagnostic Tests
Medical Management
Medications
Disease
Types and Classification
Predisposing factor
Precipitating factor
Signs and Symptoms
Side Effects
Nursing Diagnosis
Nursing Interventions
Plaque Psoriasis
 Raised and inflammed red
patches of the skin covered in
a silvery scale
 On elbows knees scalp lower
back hands and feet
 Physical Exam
- presence of the plaque-type
lesions
- signs of nail and scalp
involvement
 Family history
 Biopsy
Impaired skin integrity
 Assess skin, noting color, moisture,
texture, temperature; note
erythema, edema, tenderness.
 Identify aggravating factors and
encourage patient to avoid them.
 Advised the patient not to pick at
or scratch the affected areas
 Advice the patient to bathe or
shower using lukewarm water and
mild soap or nonsoap cleansers.
 After bathing, allow the skin to air
dry or gently pat the skin dry.
Avoid rubbing or brisk drying.
 Apply topical lubricants
immediately after bathing.
 Apply topical steroid creams or
ointments as indicated
 Apply topical
immunomodulators as indicated
 Prepare the patient for
phototherapy as indicated
Psoriasis  Injury to the skin
 Alcohol
Insert Definition here
 Metabolic Syndrome  Smoking
 Stress
 Type II Diabetes
Psoriasis  Hormonal changes
 Obesity  Medications (lithium, antima-larial, anti-
inflammatory, ACE inhibitors)
 Depression
 Streptococcal Infection
 Cardiovascular Disease Unknown Etiology  Immune Disorders
Pathophysiology
Migration of T cells, dendritic cells,
macrophages to epidermis
Release of inflammatory cells
Stimulation of keratinocyte
Vascular engorgement
proliferation
Keratinocytes migrate to
stratum corneum in
3-5 days
Keratinocytes do not lose
their nucleus
Immature Keratinocytes
Keratinocytes do not adhere well
to each other
Psoriasis
Guttate Psoriasis Inverse Psoriasis Postural Psoriasis Erythrodermic Psoriasis Nail Psoriasis
 Small, drop-shaped  Pus-filled lesions with red  Pitting nails
 Red, smooth patches of  A peeling rash that covers the
papules, scaling spots borders  Nail discoloration
inflamed skin that worsen
 On the trunk and  Widespread patches or on entire body that can itch or
with friction and sweating
small areas of the hands  Crumbling beneath free edges
proximities  On folded areas of the skin
burn intensely
and feet  Separation of the nail plate
 There is no cure, only Topical Agents Topical corticosteroids
Nonsteroidal topical
management of symptoms medications
 Lifestyle assessment
 Management of emotional  Skin irritation/redness or
factors
 Burning or stinging
small red bumps on the
sensation
 Patient education on the dis- ease skin (folliculitis)
and treatment
 Gentle removal of scales
 Encouraging patient to establish a
regular skin care routine Phototherapy UVB UVA
 Nausea and vomiting,
 Burning sensation
irritability, and
Disturbed body image Deficient knowledge insomnia.
 Assess the patient’s  Explaining the factors that
perception of changed provoke psoriasis
Systemic Agents Immunosuppressants Monoclonal antibody Fusion protein
appearance.  Explain treatment plan
 Assess the patient’s behavior  Emphasize the importance of
related to appearance. compliance  Fever or chills
 Allow patients to verbalize  Caution patient about taking  Fever or chills
 Pain in the side of the  Sore throat.
feelings regarding their skin any nonprescription  Weakness
condition. medications. lower back  Dizziness
 Headache
 Assist the patient in  Advise the client receiving  Trouble urinating  Cough
systemic cytotoxic therapy to;  Nausea ·and zomiting
articulating responses to  Pain while urinating  Nausea
questions from others continue taking the  Diarrhea
medication even if nausea and  Frequent urination  Itching.
regarding lesions and  Low BP
contagion. vomiting occur, increase fluid  Fatigue
intake, and to avoid alcoholic
 Assist patients in identifying
beverages.
ways to enhance their
 Instruct the client to avoid sun
appearance.
exposure during
photochemotherapy.
 Give the client educational
materials that include a If not treated If treated
description of the therapy
and specific guidelines
 ↑ risk of major depressive The prognosis of this disease is
disorder
the same as for the general
 ↑ risk of cardiovascular
disease population, except in cases
 ↑ psoriatic Arthritis (up to where there are associated
30% of patients) cardiovascular risk factors or
 ↑ risk of chronic desease (e.g. other diseases independent of
Crohn’s, Uveitis)
psoriasis.